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HB0081 • 2023

Hospital supplemental payments-statutory fix.

AN ACT relating to medical assistance and services; amending the Wyoming private hospital assessment act to include healthcare providers affiliated with a hospital and psychiatric residential treatment facilities; increasing permissible administrative fee amounts; increasing assessment amounts; authorizing the department of health to modify payment or qualification provisions as specified; authorizing the department of health to negotiate with the United States department of health and human services as specified; making conforming amendments; providing appropriations; authorizing an additional position; and providing for an effective date.

Budget Healthcare Taxes
Enacted

This bill passed the Legislature and reached final enactment based on the latest official action.

Sponsor
Representative Larsen, L
Last action
2023-02-28
Official status
enrolled
Effective date
7/1/2023

Plain English Breakdown

The effectiveness of these changes in improving healthcare access remains to be seen.

Fixing Hospital Supplemental Payments

This law changes rules for hospital supplemental payments to include more healthcare providers and facilities, increases fees, and allows the Department of Health to make certain adjustments.

What This Bill Does

  • Expands eligibility for Medicaid supplemental payments to include practitioners affiliated with hospitals and services provided in psychiatric residential treatment facilities (PRTFs).
  • Increases allowable administrative fee amounts from one percent to three percent of collected assessment funds.
  • Raises the maximum yearly increase in hospital assessments from half a percent to one percent without needing further approval from the legislature.
  • Authorizes the Department of Health to negotiate with federal health agencies to include these new providers and facilities under Medicaid rules.

Who It Names or Affects

  • Healthcare providers affiliated with Wyoming hospitals
  • Psychiatric residential treatment facilities (PRTFs)
  • The Department of Health

Terms To Know

Medicaid
A federal and state program that helps certain people pay for medical care.
Psychiatric Residential Treatment Facility (PRTF)
A place where individuals receive intensive mental health treatment while living there.

Limits and Unknowns

  • The law only applies to Wyoming hospitals and does not affect other states.
  • It is unclear how much additional funding will be needed beyond the initial appropriation for future years.

Amendments

These notes stay tied to the official amendment files and metadata from the legislature.

HB0081HS001

Standing Committee • House Labor, Health and Social Services Committee

Adopted

Plain English: The amendment changes the bill to adjust certain positions authorized, specify which acts are affected by the bill's provisions, modify appropriation amounts, and change funding sources.

  • Changes 'positions' to 'position' in the authorization section of the bill.
  • Specifies that the Wyoming Nursing Care Facility Assessment Act, Wyoming Private Hospital Assessment Act, and Wyoming Private Ground Ambulance Service Provider Assessment Act are affected by the bill's provisions.
  • Reduces the appropriation amount from $97,660.00 to $48,830.00.
  • Changes the funding source from 'the general fund' to 'federal funds available for this purpose'.
  • The amendment text does not provide additional context about why these specific changes are being made.
HB0081SW001

Committee of the Whole • Senator Barlow

Adopted

Plain English: The amendment adds a specific amount of money to be appropriated for hospital assessments in Wyoming.

  • Adds $48,830.00 from special revenue collected through hospital assessments to be used as appropriations.
  • The exact purpose or use of the additional funds is not specified in the amendment text.

Bill History

  1. 2023-02-28 LSO

    Assigned Chapter Number 126

  2. 2023-02-28 Governor

    Governor Signed HEA No. 0061

  3. 2023-02-24 Senate

    S President Signed HEA No. 0061

  4. 2023-02-23 House

    H Speaker Signed HEA No. 0061

  5. 2023-02-23 LSO

    Assigned Number HEA No. 0061

  6. 2023-02-22 House

    H Concur:Passed 35-26-1-0-0

  7. 2023-02-22 House

    H Received for Concurrence

  8. 2023-02-22 Senate

    S 3rd Reading:Passed 22-9-0-0-0

  9. 2023-02-21 Senate

    S 2nd Reading:Passed

  10. 2023-02-17 Senate

    S COW:Passed

  11. 2023-02-16 Senate

    S Placed on General File

  12. 2023-02-16 Senate

    S02 - Appropriations:Recommend Do Pass 5-0-0-0-0

  13. 2023-02-13 Senate

    :Rerefer to S02 - Appropriations

  14. 2023-02-13 Senate

    S10 - Labor:Recommend Do Pass 4-1-0-0-0

  15. 2023-02-02 Senate

    S Introduced and Referred to S10 - Labor

  16. 2023-01-26 Senate

    S Received for Introduction

  17. 2023-01-26 House

    H 3rd Reading:Passed 36-25-1-0-0

  18. 2023-01-25 House

    H 2nd Reading:Passed

  19. 2023-01-24 House

    H COW:Passed

  20. 2023-01-19 House

    H Placed on General File

  21. 2023-01-19 House

    H02 - Appropriations:Recommend Do Pass 7-0-0-0-0

  22. 2023-01-17 House

    :Rerefer to H02 - Appropriations

  23. 2023-01-17 House

    H10 - Labor:Recommend Amend and Do Pass 5-4-0-0-0

  24. 2023-01-11 House

    H Introduced and Referred to H10 - Labor

  25. 2023-01-06 House

    H Received for Introduction

  26. 2023-01-04 LSO

    Bill Number Assigned

Official Summary Text

Bill Summary - 23LSO-0011
Bill No.:

HB0081

Effective:

7/1/2023

LSO No.:

23LSO-0011

Enrolled Act No.:

HEA No. 0061

Chapter No.:

126

Prime Sponsor:

Larsen, L

Catch Title:

Hospital supplemental payments-statutory fix.

Subject:

Amending the Private Hospital Assessment Act

Summary/Major Elements:

This act amends the Private Hospital Assessment Act to include practitioners employed by, under contract with or in affiliation with a hospital-affiliated professional service provider group and services provided in a psychiatric residential treatment facility (PRTF). These practitioners and PRTFs are eligible to receive Medicaid supplemental payments under the Act.

This act authorizes the director of the Department of Health to negotiate with the United States Department of Health and Human Services to include these practitioners and PRTFs under the Private Hospital Assessment Act and to execute any necessary Medicaid plan amendments.

This act increases permissible administrative fee amounts and assessment amounts under the Private Hospital Assessment Act.

The above summary is not an official publication of the Wyoming Legislature and is not an official statement of legislative intent.

While the Legislative Service Office endeavored to provide accurate information in this summary, it should not be relied upon as a comprehensive abstract of the bill.

Current Bill Text

Read the full stored bill text
23LSO-0011

ORIGINAL House

ENGROSSED
Bill No
.
HB0081

ENROLLED ACT NO. 61,

HOUSE OF REPRESENTATIVES

SIXTY-SEVENTH LEGISLATURE OF THE STATE OF WYOMING
2023 General Session

AN ACT relating to medical assistance and services; amending the Wyoming private hospital assessment act to include healthcare providers affiliated with a hospital and psychiatric residential treatment facilities; increasing permissible administrative fee amounts; increasing assessment amounts; authorizing the department of health to modify payment or qualification provisions as specified; authorizing the department of health to negotiate with the United States department of health and human services as specified; making conforming amendments; providing appropriations; authorizing an additional position; and providing for an effective date.

Be It Enacted by the Legislature of the State of Wyoming:

Section 1
.

W.S. 42
‑
9
‑
102(a) by creating a new paragraph (xi), 42
‑
9
‑
103(d)(i), 42
‑
9
‑
104(b)(iii), 42
‑
9
‑
106(a) and (c) and 42
‑
9
‑
108(a) are amended to read:

42
‑
9
‑
102.

Definitions.

(a)

As used in this chapter:

(xi)

"Hospital services" means inpatient, outpatient and other services provided by a private hospital or by practitioners employed by, under contract with or in affiliation with a hospital
‑
affiliated professional service provider group. Hospital services for purposes of this act include services provided in a psychiatric residential treatment facility owned, operated by or affiliated with a private hospital.

42
‑
9
‑
103.

Private hospital assessment account.

(d)

The account shall be used exclusively for the following purposes:

(i)

To pay administrative expenses incurred by the department or its agent in performing the activities authorized by this chapter, provided that these expenses shall not exceed a total of
one percent (1%)
three percent (3%)
of the aggregate assessment funds collected in the fiscal year;

42
‑
9
‑
104.

Assessments.

(b)

The assessment due under this section shall be imposed each fiscal year in an amount calculated as a uniform percentage of each hospital's net patient revenue. The assessment rate shall be determined by the department on a prospective basis and shall be based on the percentage of net hospital patient revenue needed to generate an amount not to exceed the nonfederal portion of the upper payment limit gap plus the fee authorized by W.S. 42
‑
9
‑
103(d)(i).

In no event shall the assessment rate:

(iii)

Increase by more than
one
‑
half of one percent (.5%)
one percent (1%)
of a hospital's net patient revenue for each fiscal year following the first fiscal year in which the hospital is assessed without further approval by the legislature.

42
‑
9
‑
106.

Quarterly adjustment payments.

(a)

To preserve the quality and improve access to
private
hospital services
,

for private hospital inpatient and outpatient services rendered on or after July 1, 2016,
the department shall make quarterly adjustment payments as set forth in this section.

(c)

Quarterly adjustment payments shall not be used to offset any other payment by medicaid for hospital
inpatient or outpatient
services to medicaid beneficiaries, including without limitation any fee
‑
for
‑
service, per diem, private hospital inpatient adjustment or cost settlement payment.

42
‑
9
‑
108.

Approval of state plan; rulemaking.

(a)

The department shall seek necessary federal approval in the form of state plan amendments in order to continue to implement the provisions of this chapter.
The department shall be deemed to satisfy this requirement by seeking approval for the operation of an upper payment limit program that provides for quarterly adjustment payments. While seeking federal approval under this subsection, the department may modify payment or qualification provisions as necessary to obtain the Centers for Medicare and Medicaid Services approval if the changes do not exceed the authority and purposes of this chapter.

Section 2.

The director of the department, with the consent of the governor, shall enter into negotiations with the United States department of health and human services regarding the expansion of the scope of hospital services to include those services provided by practitioners employed by, under contract with or in affiliation with a hospital
‑
affiliated professional service provider group and services provided in a psychiatric treatment facility owned, operated by or affiliated with a hospital. The director, with the consent of the governor, is authorized to execute any necessary and prudent state Medicaid plan amendments to carry out this act. Affiliation with a hospital shall be specified in the state Medicaid plan amendment and shall include public or private hospitals as authorized by federal law.

Section 3.

There is appropriated three million eight hundred fifty thousand dollars ($3,850,000.00) from special revenue from assessments collected under W.S. 42
‑
9
‑
104 and three million eight hundred fifty thousand dollars ($3,850,000.00) from federal funds to the department of health for purposes of allowing practitioners employed by, under contract with or in affiliation with a hospital
‑
affiliated professional service provider group and psychiatric residential treatment facilities to participate in the assessments and benefits provided by the Private Hospital Assessment Act under W.S. 42
‑
9
‑
101 through 42
‑
9
‑
109 for the period beginning July 1, 2023 and ending June 30, 2024. This appropriation shall not be transferred or expended for any other purpose and any unexpended, unobligated funds remaining from this appropriation on June 30, 2024 shall revert as provided by law. It is the intent of the legislature that an appropriation to fund the hospital services authorized by this act be included in the department of health's standard budget request for the immediately succeeding fiscal biennium. The appropriations provided by this section shall only be expended if the state Medicaid plan amendment specified by this act is approved and shall be expended solely for the purposes of making provider payments or reimbursements under the amended state Medicaid plan.

Section 4.

The department of health is authorized one (1) additional full
‑
time position for the purposes of the following acts: the Wyoming Nursing Care Facility Assessment Act under W.S. 42-8-101 through 42-8-109, the Wyoming Private Hospital Assessment Act under W.S. 42-9-101 through 42-9-109 and the Wyoming Private Ground Ambulance Service Provider Assessment Act under W.S. 42-11-101 through 42-11-109. There is appropriated forty-eight thousand eight hundred thirty dollars ($48,830.00) from special revenue from assessments collected under W.S. 42
‑
9
‑
104 and forty-eight thousand eight hundred thirty dollars ($48,830.00) from the federal funds available for this purpose to the department of health for purposes of this section. This appropriation shall not be transferred or expended for any other purpose and any unexpended, unobligated funds remaining from this appropriation on June 30, 2024 shall revert as provided by law. It is the intent of the legislature that an appropriation to fund this position as authorized by this section be included in the department of health's standard budget request for the immediately succeeding fiscal biennium.

Section 5.

This act is effective July 1, 2023
.

(END)

Speaker of the House

President of the Senate

Governor

TIME APPROVED: _________

DATE APPROVED: _________

I hereby certify that this act originated in the House.

Chief Clerk

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